scholarly journals Taking Charge After Stroke: A novel, community-based intervention to improve the lives of people with stroke

2021 ◽  
Author(s):  
◽  
Vivian Fu
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Self Management ◽  
Community Based ◽  
Management Intervention ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Taking Charge

<p>Background and aims: Stroke is the third leading cause of disability worldwide. Despite the recent development of hyper-acute therapies for stroke, outcomes for people with stroke and types of rehabilitation interventions have remained unchanged. Rehabilitation in New Zealand is largely therapy-based and uses goal setting as a main component, but evidence for effectiveness of these methods is weak. Attempts to enhance the effects of rehabilitation using a stroke liaison officer or a caregiver to lead rehabilitation at home have had no effect on outcomes. However, self-management interventions have shown some promise.  The Take Charge session is a novel, community-based, self-management intervention, which was shown to significantly improve both independence and health-related quality of life at 12 months following stroke in Māori and Pacific New Zealanders. We formalised the components of the Take Charge session, based upon Self Determination Theory and qualitative research about the importance of Taking Charge in recovery. This allowed us to retest the intervention in a different population of people with stroke.  We hypothesised that: (1) the beneficial effect of the Take Charge session would be reproducible in a larger cohort of non-Māori, non-Pacific people with stroke, and (2) that two Take Charge sessions would have a greater positive effect on health-related quality of life than one alone.  Methods: We randomised 400 people within 16 weeks of acute stroke who had been discharged to community living at seven centres in New Zealand to either a single Take Charge session (TCS 1, n = 132), two Take Charge sessions (TCS 2, n = 138), or a control intervention (n = 130). The primary outcome was the Physical Component Summary score (PCS) of the Short Form 36 (SF-36) at 12 months following index stroke, comparing any Take Charge session exposure to control. Secondary outcomes included the PCS of the Short Form 12 (SF-12) at six months, participation measured by the Frenchay Activities Index at six and 12 months, and activities measured by the Barthel Index at six and 12 months. Outcome measures were performed by an assessor masked to allocation.  Results: At 12 months following stroke, participants in either of the Take Charge groups (TCS 1 + TCS 2) scored 2.9 (95% CI 0.95 to 4.9, p = 0.004) points higher (better) than control on the SF-36 PCS. This difference was statistically and clinically significant. The effect size remained significant when we adjusted for pre-specified baseline variables, including age, gender, and baseline stroke severity. Furthermore, SF-12 PCS at six months showed improvement in similar direction and effect size, and improvement in participation was statistically significant at 12 months. There was a positive dose effect with each exposure to the Take Charge session predicting a 1.9 (95% CI 0.8 to 3.1, p < 0.001) point increase in the 12-month SF-36 PCS. Subsequently, we conducted an individual patient meta-analysis of the Take Charge session, pooling data with the initial Māori and Pacific Stroke Study. The pooled effect of any exposure to the Take Charge session was 3.74 (95% CI 1.96 to 5.51) points greater than control.  Conclusion: The Take Charge session – a simple, self-management intervention, improved healthrelated quality of life and participation at 12 months. This thesis provides evidence for implementing such an intervention into routine, post-stroke care, to improve the quality of life of people with stroke in the long term.</p>

scholarly journals Taking Charge After Stroke: A novel, community-based intervention to improve the lives of people with stroke

2021 ◽  
Author(s):  
◽  
Vivian Fu
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Self Management ◽  
Community Based ◽  
Management Intervention ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Taking Charge

<p>Background and aims: Stroke is the third leading cause of disability worldwide. Despite the recent development of hyper-acute therapies for stroke, outcomes for people with stroke and types of rehabilitation interventions have remained unchanged. Rehabilitation in New Zealand is largely therapy-based and uses goal setting as a main component, but evidence for effectiveness of these methods is weak. Attempts to enhance the effects of rehabilitation using a stroke liaison officer or a caregiver to lead rehabilitation at home have had no effect on outcomes. However, self-management interventions have shown some promise.  The Take Charge session is a novel, community-based, self-management intervention, which was shown to significantly improve both independence and health-related quality of life at 12 months following stroke in Māori and Pacific New Zealanders. We formalised the components of the Take Charge session, based upon Self Determination Theory and qualitative research about the importance of Taking Charge in recovery. This allowed us to retest the intervention in a different population of people with stroke.  We hypothesised that: (1) the beneficial effect of the Take Charge session would be reproducible in a larger cohort of non-Māori, non-Pacific people with stroke, and (2) that two Take Charge sessions would have a greater positive effect on health-related quality of life than one alone.  Methods: We randomised 400 people within 16 weeks of acute stroke who had been discharged to community living at seven centres in New Zealand to either a single Take Charge session (TCS 1, n = 132), two Take Charge sessions (TCS 2, n = 138), or a control intervention (n = 130). The primary outcome was the Physical Component Summary score (PCS) of the Short Form 36 (SF-36) at 12 months following index stroke, comparing any Take Charge session exposure to control. Secondary outcomes included the PCS of the Short Form 12 (SF-12) at six months, participation measured by the Frenchay Activities Index at six and 12 months, and activities measured by the Barthel Index at six and 12 months. Outcome measures were performed by an assessor masked to allocation.  Results: At 12 months following stroke, participants in either of the Take Charge groups (TCS 1 + TCS 2) scored 2.9 (95% CI 0.95 to 4.9, p = 0.004) points higher (better) than control on the SF-36 PCS. This difference was statistically and clinically significant. The effect size remained significant when we adjusted for pre-specified baseline variables, including age, gender, and baseline stroke severity. Furthermore, SF-12 PCS at six months showed improvement in similar direction and effect size, and improvement in participation was statistically significant at 12 months. There was a positive dose effect with each exposure to the Take Charge session predicting a 1.9 (95% CI 0.8 to 3.1, p < 0.001) point increase in the 12-month SF-36 PCS. Subsequently, we conducted an individual patient meta-analysis of the Take Charge session, pooling data with the initial Māori and Pacific Stroke Study. The pooled effect of any exposure to the Take Charge session was 3.74 (95% CI 1.96 to 5.51) points greater than control.  Conclusion: The Take Charge session – a simple, self-management intervention, improved healthrelated quality of life and participation at 12 months. This thesis provides evidence for implementing such an intervention into routine, post-stroke care, to improve the quality of life of people with stroke in the long term.</p>

Factors Affecting Health-Related Quality of Life After the Arterial Switch Operation

2021 ◽  
Vol 12 (3) ◽  
pp. 344-351
Author(s):  
Julie Cleuziou ◽  
Anna-Katharina Huber ◽  
Martina Strbad ◽  
Masamichi Ono ◽  
Alfred Hager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Arterial Switch Operation ◽  
Health Related Quality ◽  
Switch Operation ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Cardiac Medication

Background: Long-term morbidity and mortality outcomes of the arterial switch operation (ASO) in patients with transposition of the great arteries and Taussig-Bing anomaly are excellent. With an increasing number of patients reaching adolescence and adulthood, more attention is directed toward quality of life. Our study aimed to determine the health-related quality of life (hrQoL) outcomes in patients after the ASO and identify factors influencing their hrQoL. Methods: In this cross-sectional study, hrQoL of patients after ASO was assessed with the German version of the Short Form-36 (SF-36) and the potential association of specified clinical factors was analyzed. Patients of at least 14 years of age who underwent ASO in our institution from 1983 were considered eligible. Results: Of the 355 questionnaires sent to eligible patients, 261 (73%) were available for analysis. Compared to the reference population, patients who had undergone ASO had a significantly higher score in all subscales of the SF-36 except for vitality ( P < .01). Patients with an implanted pacemaker ( P = .002), patients who required at least one reoperation ( P < .001), and patients currently taking cardiac medication ( P < .004) or oral anticoagulation ( P = .036) had lower physical component scores compared to patients without these factors. Conclusions: Patients’ self-assessed and self-reported hrQoL after ASO (using German version of the Short Form 36) is very good. In this population, hrQoL is influenced by reoperation, the need for a pacemaker, and current cardiac medication or anticoagulant use. The development of strategies designed to mitigate or minimize the requirements for, and/or impact of these factors may lead to better hrQoL in this patient population.

scholarly journals Eccentric Cycling Training Improves Health-Related Quality of Life in Adolescents with Obesity

Obesity Facts ◽  
2020 ◽  
Vol 13 (6) ◽  
pp. 548-559
Author(s):  
Valérie Julian ◽  
David Thivel ◽  
Maud Miguet ◽  
Bruno Pereira ◽  
Céline Lambert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Composition ◽  
Short Form ◽  
Health Related Quality ◽  
Functional Changes ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Cycling Training

<b><i>Introduction:</i></b> While eccentric (ECC) training appears to be more efficient than concentric (CON) training at improving body composition in adolescent with obesity, its impact on health-related quality of life (HRQOL) has never been studied. <b><i>Objective:</i></b> The aim of this study is to compare the effects of 2 cycling training modalities, i.e., ECC vs. CON, in adolescents with obesity on HRQOL and health perception (HP). <b><i>Methods:</i></b> A total of 24 adolescents with obesity, aged 12–16 years, were randomized to either a 12-week ECC or a CON cycling training program performed at the same oxygen consumption (VO<sub>2</sub>). Anthropometric measurements, body composition, maximal incremental tests, HRQOL (Vécu et Santé Percue de l’Adolescent [VSP-A], Medical Outcome Study Short Form [SF-36]), and HP were assessed at before and after training. <b><i>Results and Conclusion:</i></b> Both CON and ECC cycling trainings promoted significant improvements in BMI, VO<sub>2peak</sub>, total fat mass, and fat-free mass, with better improvements in body composition parameters in the ECC group (<i>p</i> &#x3c; 0.05). The VSP-A total score increased after CON (<i>p</i> &#x3c; 0.01) and ECC (<i>p</i> &#x3c; 0.001) training, with better enhancement for the ECC group (<i>p</i> &#x3c; 0.05). The SF-36 physical score increased after both CON (<i>p</i> &#x3c; 0.01) and ECC (<i>p</i> &#x3c; 0.001) trainings. The global HP score increased only after ECC training (<i>p</i> &#x3c; 0.001). Except for the energy-vitality item, no significant correlation was found between changes in HRQOL and its subdomains and anthropometric, body composition, and functional parameters. Both ECC and CON cycling trainings are associated with positive changes in HRQOL and HP. However, ECC seems to induce greater improvements in HRQL and HP than CON cycling training, which is probably not due to the anthropometric, body composition, and functional changes.

scholarly journals Health-related quality-of-life assessment in patients with low back pain using SF-36 questionnaire

Medicina ◽  
2007 ◽  
Vol 43 (8) ◽  
pp. 607 ◽  
Author(s):  
Kotryna Vereščiagina ◽  
Kazys Ambrozaitis ◽  
Bronius Špakauskas
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Short Form ◽  
Bodily Pain ◽  
Low Back ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Objective. For complete assessment of benefits of the surgical intervention, it is essential to provide evidence of the impact on patients in terms of health status and healthrelated quality of life. In the present study, the preoperative 36-item Short Form (SF-36) Health Survey scores were determined in patients before lumbar microdiscectomy due to better preoperative screening likewise in the control group – almost healthy population taken into account any habitual ailments experienced in an appropriate age. Patients and methods. In the present study, we investigated a cohort of 100 patients with disc herniation causing low back pain and another hundred of the control subjects, matched by age and gender. The short form 36 general health questionnaire (SF-36) was applied. Results. Estimation of the SF-36 scores showed that (1) all of the domain values were considerably lower in the preoperative patient group than in the second one (P<0.01); (2) the bodily pain scores were closely correlated to the social function scores (R=0.7, P<0.01), whereas the physical function was less related to the bodily pain (R=0.6, P<0.01). The weakest correlation was observed between bodily pain and mental health and general health (R=0.4, P<0.01). Conclusion. The present study showed that the generic instrument, SF-36 Health Survey, was optimized paraclinical method for patients predisposed to surgical treatment of the lumbar disc herniation disease likewise for normal population individuals, matched by age and sex, in the assessment of health-related quality of life.

scholarly journals Effects of the “Living well with COPD” intervention in primary care: a comparative study

2018 ◽  
Vol 51 (1) ◽  
pp. 1701375 ◽  
Author(s):  
Claudia Steurer-Stey ◽  
Kaba Dalla Lana ◽  
Julia Braun ◽  
Gerben ter Riet ◽  
Milo A. Puhan
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Usual Care ◽  
Self Management ◽  
Health Related Quality ◽  
Management Intervention ◽  
Living Well ◽  
Related Quality ◽  
Health Related

The pivotal objective of chronic obstructive pulmonary disease (COPD) self-management programmes is behaviour change to avoid moderate and severe exacerbations and improve health related quality of life.In a prospectively planned, controlled study, COPD patients who participated in the “Living well with COPD” (LWWCOPD) self-management intervention were compared with usual care patients from the primary care COPD Cohort ICE COLD ERIC, who did not receive self-management intervention (NCT00706602) The primary outcome was behaviour change and disease-specific health related quality of life after 1 year. Secondary end-points included exacerbation rates. We calculated mixed linear, zero-inflated negative binomial and logistic regression models and used propensity scores to counteract confounding.467 patients, 71 from the LWWCOPD and 396 from the usual care cohort, were included. The differences between intervention and control were 0.54 (95% CI 0.13−0.94) on the Chronic Respiratory Questionnaire domain “mastery”, 0.55 (95% CI 0.11−0.99) on “fatigue”, 0.54 (0.14−0.93) on “emotional function” and 0.64 (95% CI 0.14−1.14) on “dyspnoea”. The intervention considerably reduced the risk of moderate and severe exacerbations (incidence rate ratio 0.36, 95% CI 0.25−0.52).Self-management coaching in primary care improves health-related quality of life and lowers exacerbation rates and health care use.

scholarly journals Predictors of itch and pain in the 12 months following burn injury: results from the Burns Registry of Australia and New Zealand (BRANZ) Long-Term Outcomes Project

2020 ◽  
Vol 8 ◽  
Author(s):  
Lincoln M Tracy ◽  
Dale W Edgar ◽  
Rebecca Schrale ◽  
Heather Cleland ◽  
Belinda J Gabbe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Severe Pain ◽  
Burn Injury ◽  
Short Form ◽  
Bodily Pain ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract Background Itch and pain are common complaints of patients with burn injuries. This study aimed to describe the prevalence and predictors of itch and moderate to severe pain in the first 12 months following a burn injury, and determine the association between itch, moderate to severe pain, work-related outcomes, and health-related quality of life following a burn injury. Methods Burn patients aged 18 years and older were recruited from five Australian specialist burn units. Patients completed the 36-item Short Form Health Survey Version 2 (SF-36 V2), the Sickness Impact Profile (SIP) work scale, and a specially developed questionnaire relating to itch at 1, 6, and 12 months post-injury. Moderate to severe pain was defined as a score less than 40 on the bodily pain domain of the SF-36 V2. Multivariate mixed-effects regression models were used to identify patient and burn injury predictors of itch and moderate to severe pain. Results Three hundred and twenty-eight patients were included. The prevalence of itch decreased from 50% at 1 month to 27% at 12 months. Similarly, the prevalence of moderate to severe pain decreased from 23% at 1 month to 13% at 12 months. Compared to patients aged 18-34, the adjusted odds of experiencing any itch were 59% (95% CI: 0.20, 0.82) and 55% (95% CI: 0.22, 0.91) lower for patients aged between 35 and 49 and ≥ 50 years, respectively. Compared to patients aged 18-34, the adjusted odds of experiencing moderate to severe pain were 3.12 (95% CI: 1.35, 7.20) and 3.42 (95% CI: 1.47, 7.93) times higher for patients aged 35-49 and ≥ 50 years, respectively. Conclusions Less than 15% of patients reported moderate or severe pain at 12 months, while approximately one-quarter of the patients reported itch at the same period. The presence of moderate to severe pain was associated with a greater negative impact on health-related quality of life and work outcomes compared to itch. Further research is needed to improve our ability to identify patients at higher risk of persistent itch and pain who would benefit from targeted review and intervention studies.

scholarly journals Improved Health-Related Quality of Life After Surgical Management of Severe Refractory Constipation-Dominant Irritable Bowel Syndrome

2015 ◽  
Vol 100 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Jennifer Y. Lam ◽  
Biniam Kidane ◽  
Farouq Manji ◽  
Brian M. Taylor
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Surgical Management ◽  
Short Form ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Irritable Bowel

Abstract Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders (FGIDs). Despite its prevalence and health-care costs, there are few effective therapies for patients with severe symptoms. Our objective was to determine whether surgical management would improve health-related quality of life (HRQOL) in severe refractory constipation-dominant FGIDs. From 2003 to 2005, 6 patients underwent total colectomy with end ileostomy or primary anastomosis. They completed Short Form 36 (SF-36) and IBS-36 questionnaires preoperatively and postoperatively. HRQOL was compared with age- and sex-matched Canadian norms using Welch's unpaired t test. Preoperative SF-36 physical and mental health summary scores were significantly lower than Canadian norms (P &lt; 0.0001), while postoperative scores were not significantly different than Canadian norms (P = 0.50 and P = 0.57, respectively). After surgical management, HRQOL in patients with severe constipation-dominant IBS improved from drastically below that of Canadian norms to a comparable level. This finding questions the convention of avoiding operations in IBS patients and demonstrates that surgical management may be suitable for the appropriately screened patient.

The Combined Effect of Acupuncture and Tanacetum parthenium on quality of life in women with headache: Randomised study

2012 ◽  
Vol 30 (4) ◽  
pp. 252-257 ◽  
Author(s):  
Eliane Cristina Ferro ◽  
Angelo Piva Biagini ◽  
Ícaro Eduardo Fuchs da Silva ◽  
Marcelo Lourenço Silva ◽  
Josie Resende Torres Silva
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Combined Treatment ◽  
Life Assessment ◽  
Randomised Study ◽  
Tanacetum Parthenium ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Background The aim of the present study was to investigate the efficacy and tolerability of acupuncture (AC), Tanacetum (TAN) or combined treatment on quality of life in women with chronic migraine (CM). Methods A total of 69 women volunteers were randomly divided into 3 groups: AC, acupuncture administered in 20 sessions over 10 weeks (n=22); TAN, at 150 mg/day (n=23); and AC+TAN (n=23). The primary outcome was Short-Form 36 (SF-36) quality of life assessment score. Secondary outcomes included the Migraine Disability Assessment (MIDAS) and visual analogue scale (VAS) score experienced after randomisation. Results AC+TAN was statistically significantly more effective than AC or TAN alone in overall health-related quality of life (SF-36; p<0.05), on MIDAS score (−35.1 (10.6) AC vs −24.8 (11.7) TAN vs −42.5 (9.8) AC+TAN; p<0.05) and in reducing the mean score of pain on VAS (−5.6 (2.4) AC vs −3.7 (2.1) TAN vs −6.4 (3.1) AC+TAN; p<0.05). Conclusions The present work shows an improvement of the quality of life and better analgesic effect of acupuncture combined with TAN treatment on migraine pain in women when compared with acupuncture or TAN alone.

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